Getting a hair transplant at 21-22? (Photo)

Question

So, I'm 21 and I noticed at about 18 that I started balding. I'm guessing it started much earlier though as I had long hair and couldn't really notice other than I had a receded hairline already. It's getting pretty bad and I was curious if it would even be something I should consider. I pretty much have the same hairline/thinning already as my father and he's 51. Bald spots/receded hairline but not the horseshoe bald. Here are a few pictures

Jae Pak, MD · Answer

It is unfortunate that you are losing hair at such young age.  Nevertheless, I still advocate a good exam and history for a diagnosis (make sure there isn't other issues for hair loss other than genetic balding).  Then you and the doctor can discuss options.  "SHOULD I have a hair transplant surgery", is the wrong question.  You need to understand all your options then determine YOU WANT.  For example, hair transplant may NEVER meet your expectations when you are completely bald and have just sparse coverage.  Is that acceptable to you?  Everyone is different.Maybe you want to shave your head one day and a hair transplant will leave you with scarring that you'll be  self conscious about.  FUE still leaves a scar despite what you read.Maybe you'll find out Scalp MicroPigmentation (SMP) may work for you.Maybe you'll realize you're not ready for any of this and try taking Propecia before you decide.You need a MASTER PLAN.

Kapil Dua, MBBS, MS · Answer

Usually, we try to wait till the baldness pattern sets in the young people but in your case, it is already well settled, so you can go in for one sitting of hair transplant right now. However, you should understand that the expectation should be realistic ( skin cover) and multiple sittings will be required to cover the bald area from front to back side. Also, your baldness may still increase further laterally and you may require more grafts over there also.

Greg Williams, FRCS (Plast) · Answer

Usually hair transplants are not advisable in young men but as your loss is quite extensive you might benefit from a procedure if you are willing to accept a conservative approach initially. This might involve a high hairline and narrow forelock  - something that helps to bridge the gap and frame your face. I suggest you see an ethical hair transplant surgeon who can discuss the options with you. You might also want to consider using medication to try and slow down further loss.

Amiya Prasad, MD - Account Suspended · Answer

For many years, the standard therapy in the hair loss industry has been
hair transplant. Unfortunately, it is never advisable for someone in their
early 20s to get a hair transplant. The simple reason is when you are losing
hair as quickly as you are, there aren’t enough hairs to cover the area of hair
loss.

I’m a board certified cosmetic surgeon. I trained in the time when hair
transplants were done with big, round plugs that were taken out and placed in
the scalp. I’ve lived through the different evolutions including micrografts,
minigrafts and now follicular unit extraction. These are all great advancements
and certainly the procedure has improved in some ways. However, regardless of
the technology and the names, there’s only one simple physiologic reality -
your donor area or the area at the back of the scalp has limited number of
hairs.

In our practice, we developed a treatment called Hair Regeneration. In
fact, we developed a company at this point called Trichostem® Hair Regeneration
because of its success. Essentially, we’re trying to bring
the technology and methods to treat hair thinning by not doing hair transplant
but using an injection treatment. This treatment has a combination of
platelet-rich plasma (PRP) derived from your own blood combined with Acellular
matrix which is a wound-healing agent. Close to a 100% of our male patients see
improvement.

I’m always anxious to help people understand that the earlier we catch
someone, the better the results. If we can catch somebody as young as 18, we
treat them. We haven’t treated anyone under 18 for pattern hair loss but we do
treatment in this age especially when there’s clearly a family history which we
can confirm either from microscopic or biopsy.

You would be a better candidate for treatment like Hair Regeneration
although we can never guarantee success. Sometimes, people are losing hair very
aggressively and we may not catch them soon enough to get back as much hair as
we would like. Certainly I would say that this is a better option to consider
than a surgical hair transplant.

At this point, it’s advisable that you learn more about these options.
You should also think about finasteride, but I’m not sure if it’ll be of any
value to you. However, in our practice, patients who come to us from all over
the world are very much against the use of finasteride because of fear of
long-term sexual side effects. Clearly, we have been able to improve that our
treatment works independent of pharmacologic assistance. I hope that was
helpful, I wish you the best of luck, and thank you for your question.

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William Rassman, MD (retired) · Answer

This appears to be an advanced hair loss pattern. Your
biggest enemy is the progressive balding that you seem to be experiencing and there is a good possibility that you will develop a Class 6-7 pattern like your dad.  The degree of balding that you are showing would suggest that before
you undertake a hair transplant, you try the drug finasteride for one year. At your age, the drug MAY reverse some of the balding. Get
Bulk Measurements of your hair with the HAIRCHECK instrument to determine the degree of the progression or if
you successfully stopped or reversed the hair loss with this drug once you start it. If you are developing a more
advanced balding pattern as it appears that you are, the Bulk Measurements will show over a one year
time frame, if you are reversing it and you and your doctor need to develop a MASTER PLAN from then forward. .

The older you are, the easier it is to predict future hair
loss. At 22 years old, it might be difficult if you are not destined to be a
Class 6 or 7 pattern, but in your late 20s, the job of predicting is easier. It sure looks like a Class 6 pattern at the least at this early time and people your age, who develop advanced balding may not be candidates for hair transplants. 
Don't jump to a hair transplant too quickly as
you might find out that you might have a Class 6 or 7 balding pattern men. consider alternatives like Scalp Micropigmentation (see web reference below) as a non-surgical cosmetic solution for hair loss in advanced balding in a young man.

Michael Meshkin, MD - Account Suspended · Answer

Usually we will wait until male pattern hair loss is established.  However yours is already established at this young age.  One thing to consider is that if your degree of hair loss is at this stage at this young age, since hair loss is progressive you will have a very advanced hair loss.  You can benefit from hair transplant, but you need to have realistic expectations for the future hair loss.

Sheldon S. Kabaker, MD FACS (retired) · Answer

It appears that you will have a horseshoe pattern baldness in a few years. You could first consider trying a shaved head style. Hair tranplants could be done with the realistic expectation of a thinning, mature ( but natural) look for many years to come.

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